How often does spirometry testing induce cardiac arrhythmias?

AIMS To describe the frequency and type of arrhythmia induced by forced expiratory and inspiratory flow-volume loop manoeuvres. METHODS 735 subjects (548 men) aged from 10 to 98 years old (mean 54 years, SD +/- 15) were submitted to a conventional medical examination and spirometry testing prior to a maximal cardiopulmonary exercise test (CPET). A continuous digital electrocardiogram (ECG) was recorded during spirometry and CPET, and later reviewed and interpreted by the same physician (who supervised all the procedures). RESULTS 470 subjects (64%) had cardiac arrhythmias during one or both procedures. About 60% of the arrhythmias were supraventricular, but 35 subjects (5%) presented more complex arrhythmias including frequent premature ventricular beats (n=31) or non-sustained ventricular tachycardia (n=4). While arrhythmias were more often exposed by the CPET (p<0.01), in 68 cases (10% of the total sample) arrhythmias were only induced by spirometry; these included four cases of non-sustained supraventricular tachycardia (n=4). CONCLUSIONS Spirometry is a safe procedure with regard to induction of cardiac arrhythmias. Spirometry-induced arrhythmias tend to be simple and were always short-lasting. In some cases, ECG recording during spirometry showed arrhythmias that would not be induced by a progressive maximal exercise test.